Archive for January, 2011

Per Anna, it has been sometime since I wrote a blog. Not really sure what to write. I do have a few I have been thinking about writing. About the use of ten-codes (10-4. 10-42. 10-19) and how it annoys the crap out of me. Another on my take of EMS2.0, or even another about geocaching.

For now though, I suppose I shall catch family up on what has been going on.

Anna took, and passed her Certified Nursing Assistant exam and practical’s. She is now certified as a C.N.A. The bad news is though, that she has hurt her knee again. This is the same knee and same injury location as happened a few years ago. Luckily we do have great insurance this time, so we should be able to avoid adding onto our debt. She is working at a prominent nursing home in Geneva at this time. I choose not to put the name of her employee out there for the same reason I don’t with mine. She has a forty-five minute drive to get to work tough. Kind of extreme, so she is looking for work closer to home.

I am loving my job still. I have not joined the nearby volunteer fire department yet though. Mainly because I want to get my car back on the road so I can respond when the tones drop. I have a constant debate going on in my head over when and how to upgrade my license to allow me to do more. I also need to start working on my Continuing Medical Education credits here real soon.

My car has been off the road for around a month now. It is stuck in reverse. Hopefully I will get it towed this Friday to a local garage to have it fixed. The biggest concern is the cost though, as we do not know exactly what is wrong with it. It could be something simple, or I could need a new transmission, again.

Anna’s car is on its last legs. Or wheels I suppose. It needs an inspection, before that it needs one new tire, and possibly some major work done to the steering. Our plan is to limp it along till the tax returns come, and then use them as a down payment on a new used car for her, or getting it fixed for another year. The biggest conundrum with this is we do not know if some tax money will need to be used to fix my car.

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The following does not represent my employer, nor does it represent the views of my employer. Rather it represents EMS in general. And my opinion.

I am new to EMS, only being in it for 2 years. So disregard this if you want.

The EMS system is flawed. There I said it. Many of us know it already though.

The biggest flaw I can think of is a simple one really. Some one with the sniffles calls 911, 911 dispatches an ambulance, the ambulance takes them to the ED. Now, that took an ambulance out of service, took up a bed and staff at the ED, and cost the patient hundreds if not a thousand dollars. I don’t have a problem with the ambulance doing the transport really. Most of the time another crew is standing by to take the next emergency call. My problem is transporting that patient to the ED. Why not just go to a local Urgent Care, or even the patients doctor if allowed? How much money would that save the patients insurance company? Effectively lowering insurance premiums? It would free up room and staff at the ED as well. How many times have you driven yourself to the Emergency Department, just to wait 2-10 hours to get seen? We all know that while you wait in the waiting room, whether it be with sniffles your self, or a more serious condition, there is someone sitting in a bed, sniffing or holding their stomach with indigestion. If we could transport to an Urgent Care, the more serious patients would get better care in the ED.

There are other flaws of course. Time on scene is one I hear about often from my patients, and family members. I have worked with some partners who get on scene, and as soon as the patient is in the rig, we are moving. There have been others who spend a rather large amount of time on scene. I have been on scene for 45 minutes before, while my partner works in the rig. Now, there are certain things that need to be done before transport begins, I understand this. I, myself, like to get a set of vitals before transport begins. Even if I got a set in the house or outside. I get in that rig, and take another set. Then we go. It doesn’t take long for a good set of vitals. ALS providers have things to do. IVs to start, 12-leads to do. I understand that as well. And it is fine to do them before we go, just as, I as a BLS provider, do certain thing’s before moving. But there comes a point where just sitting on scene gets ridiculous. Some things can be done during transport. Just think of how it looks to the family or bystanders. The ambulance comes screaming in, the medics jump out, grab their stuff and go in. Do their thing and wheel the patient out on the stretcher. Load them into the ambulance. Then sit there, and sit there, and sit there. If you do spend a while on scene, let the family know why at least. It is the professional thing to do.

Education I like to learn, I can sit down with a manual and just read it. But when I was attending class, there where something’s our instructor covered real fast, saying we don’t need to know it. But then, it was on the test. And besides, why would it be in the book, and on his syllabus, if it wasn’t important? Maybe this was just my instructor, I do not know. As I am new to EMS, this may be just me. But from what I read online, it is a big deal. The US in general could revamp education.

EMS2.0- This is a big topic for EMS bloggers. And I figure it is my turn to chime in. Some people look at ems2.0 as expanding our box and scope of practice. I figure, we a need new a box. A lot of the old timers in EMS don’t think anything needs to change. I disagree, we should be able to transport to Urgent Cares, time on scene should be modified, education should be revamped, BLS providers should have capabilities such as the King airway. But none of this will happen while we are looked at as “Ambulance Drivers”. To get EMS2.0 to truly take effect, we must get the publics support. Until the recognize this as a career, and demand better care. It will not happen. The more EMS providers we got onboard, the better. But with out the publics support, the old-timers will not recognize the need for change.

Thoughts? I would love some feedback.

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Well, another year has come and gone. The earth has faithfully made its orbit with out killing us all. Last year was a good year for me, and I needed it. For starters no one close to me died, always nice. I got my EMT-B card. And I got job at a private ambulance company, one of the best in NYS. I moved out of my in-laws, and Corning all together, which got me away from some memories I had been trying to escape. Anna got her tonsils out, good because she had 7 strep throat infections before June in 2010, that was crazy. I hit some huge milestones in geocaching, which had its ten-year anniversary as well. I met some great people and made some good friends.

2011? I do have new year resolutions, but they are not for public forum! I am ready for the new year, I hope it is a great one. I want to work on improving my health, both physically and emotionally. I plan on spending more time with family, and getting a puppy. Just don’t tell my landlord we want a dog!

As far as my career goes, I will join a local Volunteer Ambulance/FD, and just enjoy being an EMT-B for another year. Then I plan on moving up to ALS. I will push EMS2.0 of course! I am contemplating a blog on it soon, for those of you who don’t know what it is.